Is it safe to start taking fish oil and other supplements 3 weeks after a laparoscopic myomectomy (minimally invasive surgical procedure to remove uterine fibroids)?

Resuming Fish Oil and Supplements After Laparoscopic Myomectomy

Fish oil/omega-3 supplements are safe to restart immediately at 3 weeks post-laparoscopic myomectomy, as they do not increase bleeding risk and may support recovery. 1

Fish Oil: Explicitly Safe to Resume

• Fish oil/omega-3 fatty acids can be safely continued throughout the perioperative period and do not require any hold period before or after surgery. 2, 1

• The Society for Perioperative Assessment and Quality Improvement (SPAQI) explicitly states that fish oil preparations should be continued until surgery, contradicting older concerns about bleeding risk. 1

• Prior bleeding concerns with omega-3 supplements have been disproven in prospective studies, making them one of the few supplements with no perioperative restrictions. 3

• At 3 weeks post-laparoscopic myomectomy, the critical bleeding risk period has passed—laparoscopic myomectomy typically shows minimal blood loss (mean hemoglobin reduction of only 1.1 g/dL) and no significant postoperative complications. 4

Other Supplements: Risk-Stratified Approach

Safe to Resume at 3 Weeks

The following supplements are safe to restart at 3 weeks postoperatively and may provide benefit:

• Melatonin is safe perioperatively and may reduce anxiety and delirium. 2
• German chamomile reduces anxiety without CNS interference. 2
• Passionflower has anxiolytic effects with a good safety profile. 2
• Lavender is safe for anxiety without anesthetic potentiation. 2
• Valerian is safe and may protect against cognitive dysfunction. 2

Supplements Requiring Caution

The general principle is that supplements impairing coagulation should only be restarted once the risk of postoperative bleeding is minimal. 2 At 3 weeks post-laparoscopic myomectomy, most patients have completed wound healing, but the following should still be approached cautiously:

High Bleeding Risk - Consider Waiting Longer

• Ginkgo displaces platelet-activating factor and decreases coagulation. 2
• Ginger inhibits thromboxane synthetase with decreased platelet aggregation. 2
• Garlic has antiplatelet effects and may increase bleeding. 2
• Turmeric inhibits platelet aggregation via thromboxane metabolism and inhibits thrombin and factor Xa. 2
• Vitamin E has antiplatelet effects related to protein kinase C inhibition, worsened when taken with aspirin. 2
• Bromelain increases bleeding risk. 2

Supplements to Avoid Entirely

• Kratom has opioid-like properties and is explicitly not recommended by SPAQI, with FDA warnings against its use. 2, 3
• Garcinia cambogia contains hydroxycitric acid associated with hepatotoxicity and should be avoided. 3

Clinical Context for Laparoscopic Myomectomy

• Laparoscopic myomectomy is a safe procedure with minimal complications—studies show no intra- or postoperative complications, average hospital stay of 54 hours, and return to work within 20 days. 4

• By 3 weeks postoperatively, patients typically have substantial improvement in quality of life and symptom severity, with most having returned to usual activities. 5

• The critical wound healing period for myomectomy is largely complete by 3 weeks, making this an appropriate time to resume most supplements that don't carry significant bleeding risk. 6

Practical Recommendation

Start fish oil immediately—it carries no bleeding risk and may support recovery through anti-inflammatory properties. 1 For other supplements, assess each individually based on the categories above, with particular caution for antiplatelet agents if any abnormal bleeding or healing concerns exist. Always disclose all supplement use to the surgical team, as lack of standardization creates unpredictability. 2